Physical Therapy Working For You: Anterior Cruciate Ligament Tear

Disease Process
Causes
Symptoms
Diagnosis
Treatment
Physical Therapy
Patient Resources

Facts

“Unhappy Triad” is made up of the ACL, the PCL and the medial meniscus

More females than males sustain ACL injuries

You do not always need a surgical repair to treat a torn ACL

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Anterior Cruciate Ligament Tear (ACL)
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Anterior Cruciate Ligament Tear

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Disease Process

There are two “cruciate” ligaments in the knee; the anterior (ACL) and the posterior (PCL). These ligaments crisscross to give stability to the knee. Often times there will be a meniscus injury along with the ACL tear. The ACL has several functions in the knee. It prevents the lower leg from moving forward on the upper leg, it prevents hyperextension on the knee, it help stabilize the knee in side to side movements (thus protecting the meniscus), and helps control the amount of rotation the lower leg has at the knee joint.

Causes
The ACL is most commonly torn by a rapid change in direction (usually while running), stopping suddenly while running, or landing from a jump. The ACL can also be torn from an injury such as slipping on ice, impact during a car accident or having an object fall on the knee.

Symptoms

Patients usually report hearing a “pop” and feel a sudden “giving way” sensation in the injured knee. Soon after, the knee begins to hurt and has noticeable swelling.

Diagnosis
A diagnosis of an ACL tear is usually made using a combination of the following:

Medical History
Physical Exam (including the Lachman's Test: doctor will pull shin bone forward to see if they can feel too much motion)
X-ray
MRI: will show if the ligament is torn or cartilage is damaged.

Current Treatment
V

How Can Physical Therapy Help

The final goal of physical therapy for a patient that has suffered an ACL tear is a return to as much function as possible; whether or not the patient has received surgical repair. For those patients that choose NOT to have surgery, PT will assist in decreasing pain and swelling, increasing range of motion (ROM) and strength and gradually re-introducing activities. When surgical repair is done, rehabilitation will take longer (average 3+ months) but the stages are the same: controlling pain and swelling in the knee, recovery of ROM and strength, and finally a graduated return to full activity. Strengthening exercises are a large component to either program and the physical therapist will make sure that these exercises are done safely and in the proper progression. In either case, therapy is extremely important to help maintain knee joint function and decrease the amount of degenerative wear and tear.

Patient Resources

American Academy of Orthopedic Surgeons:

Women and ACL Injuries

ACL Reconstruction

Knee Ligament Injuries

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